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Depression measures that include somatic symptoms may inflate severity
estimates among medically ill patients, including those with cardiovascular
disease.

Aims

To evaluate whether people receiving in-patient treatment following acute
myocardial infarction (AMI) had higher somatic symptom scores on the Beck
Depression Inventory–II (BDI–II) than a non-medically ill control
group matched on cognitive/affective scores.

Method

Somatic scores on the BDI–II were compared between 209 patients
admitted to hospital following an AMI and 209 psychiatry out-patients matched
on gender, age and cognitive/affective scores, and between 366 post-AMI
patients and 366 undergraduate students matched on gender and
cognitive/affective scores.

Results

Somatic symptoms accounted for 44.1% of total BDI–II score for the
209 post-AMI and psychiatry out-patient groups, 52.7% for the 366 post-AMI
patients and 46.4% for the students. Post-AMI patients had somatic scores on
average 1.1 points higher than the students (P<0.001). Across
groups, somatic scores accounted for approximately 70% of low total scores
(BDI–II <4) v. approximately 35% in patients with total
BDI–II scores of 12 or more.

Conclusions

Our findings contradict assertions that self-report depressive symptom
measures inflate severity scores in post-AMI patients. However, the
preponderance of somatic symptoms at low score levels across groups suggests
that BDI–II scores may include a small amount of somatic symptom
variance not necessarily related to depression in post-AMI and non-medically
ill respondents.